Figure 1.

An asymptomatic 63-year-old patient with ulcerated severely stenotic internal carotid artery plaque. Colour Doppler image (A) shows the presence of echogenic plaque in the origin of internal carotid artery. Due to overwriting artifact, the plaque’s border cannot be accurately detected, while the plaque appears irregular. On CEUS (B), an ulceration is detected (arrowhead), and the severely stenotic lumen can be followed. Note the presence of calcification projected in this contrast-specific image (arrow), which should not be mistaken for intraplaque neovessels or ulceration. MDCTA (C) confirming CEUS findings and the presence of ulceration (arrowhead). CEUS, contrast-enhanced ultrasound; MDCTA, multi-detector computed tomography angiography.